Predicting Pain Outcomes in Older Veterans

A study of pain in the older veteran population concludes that while many experience improvement in pain intensity over time, this effect is mitigated by the presence of some mental health and pain conditions and higher rates of opioid consumption. The research, conducted by the Department of Veterans Affairs Center to Improve Veterans Involvement in Care and Oregon Health & Science University, sought to identify clinical and demographic factors associated with changes in pain scores over time in a national cohort of veterans 65 and older with chronic pain. Almost two-thirds of the study cohort exhibited sustained improvement during the 12 month follow up period, according to the authors; however, the presence of conditions such as mental health problems, chronic low back pain, neuropathies, and fibromyalgia/myofascial pain were associated with lower rates of sustained improvement. Also, the initiation of opioid therapy was found to reduce the likelihood for sustained improvement. The findings are reported in the July issue of Journal of Pain.

The study of 13,000 veterans receiving treatment in the VA system found that the oldest group in the sample exhibited the most reduction in pain intensity, confirming prior observations that older people may adjust and cope better with their pain over time. However, lead author Steven Dobscha, MD, noted, “We found that older veterans often show improvements in pain intensity over time, and that opioid prescriptions, mental health conditions, and certain pain diagnoses are associated with lower likelihood of improvement.” Further research is needed, according to Dr. Dobscha, to study the relationship between opioid therapy and treatment outcomes over time.